Human Papillomavirus (HPV) Fact Sheet

What is HPV?

Genital human papillomavirus (or HPV) is the most common sexually transmitted disease (STD, commonly known as sexually transmitted infection, STI). Some types of genital HPV primarily infect skin near the genitals and anus. Of the more than 40 types of genital HPV, two cause more than 70 percent of cervical cancers and two others cause more than 90 percent of genital warts. Risks can be reduced through vaccination, the use of condoms, and regular Pap tests.

How do people get HPV?

HPV is passed by direct skin-to-skin contact during vaginal, anal, and oral sex with someone who has this infection. Most cases of HPV are spread by partners who don't have visible signs or symptoms and don't know they have the virus.

Very rarely, pregnant women with HPV can transmit the virus to their baby during delivery. When this happens, it can result in the baby developing warts in the airways (a condition known as recurrent respiratory Papillomatosis, or RRP). This happens so infrequently, though, that pregnant women with HPV are routinely recommended to have their babies through a vaginal delivery rather than Caesarean section.

How common is HPV?

HPV is one of the most common sexually transmitted infections in the world. At least 50 percent of sexually active people will get genital HPV.

There are about six million new cases of HPV in the U.S. each year, according to the Centers for Disease Control and Prevention. At any one time, approximately 20 million Americans have a genital HPV infection.

What can HPV cause? What are the symptoms?

Many people with genital HPV infection have no visible symptoms, and are never diagnosed as having either HPV or a related disease. In most cases, a person's immune system will clear HPV naturally within 24 months.

Some types of sexually transmitted HPV cause genital or anal warts. Warts appear as growths or bumps and may be raised or flat, single or multiple, small or large. They tend to be flesh-colored or whitish in appearance. Some even have a cauliflower appearance. They can appear on the vulva (entire outer female genital area), in or around the vagina, on the cervix, on the penis or scrotum, in or around the anus, and in the groin. The types of HPV that cause genital warts are not associated with cervical cancer.

Other types of HPV cause changes to a woman's cervix that can put her at risk for cervical cancer if undetected. These tiny "precancerous" cell changes cannot be seen with the naked eye, but can be found as part of a cervical cancer screening exam (see Testing/Diagnosis for more). These cell changes can, but usually do not, progress to cancer.

The types of HPV that can lead to cervical cancer are also associated with much rarer cancers of the vagina, vulva, penis, anus, and head and neck.

Reduce your risk

Pap tests: Most women who are diagnosed with cervical cancer tend to have never had a Pap test or gone many years without one. Women who have regular Pap tests, either alone or in combination with HPV tests, can almost always prevent cervical cancer. Women should speak with their healthcare provider about how often they should be checked for cervical cancer.

Vaccines: There are two vaccines to protect against HPV). Both are effective at blocking infection with the HPV types most commonly cause cervical cancers. Gardasil also prevents infection with the types of HPV that typically cause genital warts.

Both vaccines – which are given in three doses over six months- are recommended for girls ages 11-12, with "catch up" vaccine for females ages 13-26 who have not previously been vaccinated against HPV. The vaccines can be given to girls as young as age nine. Both vaccines are approved to prevent cervical, vulvar, and vaginal cancers in females. Women who receive an HPV vaccine still need cervical cancer screening (such as Pap tests).

Some vaccines are also approved for prevention of genital warts and anal cancer in males and females ages 9-26.

Condoms: Male latex condoms can reduce the risk of HPV transmission for the skin they cover. Use condoms or other latex barrier (such as a dental dam) for each sex act (oral, anal, and vaginal). A barrier should be put on before any sexual contact takes place. Since condoms don't cover all genital skin, they don't provider complete protection.

Testing/Diagnosis

Healthcare providers usually diagnose warts by examining the genital area and looking closely at the skin. There is no specific test for warts.

Cervical cell changes are most often found as a result of a Pap test, in which a healthcare provider takes a sample of cells from the cervix that are sent to a lab and examined under a microscope. Pap testing is often done in combination with an HPV test, a special test that determines if a woman has the types of HPV that can cause cervical cancer.

HPV tests are approved for use (along with a Pap test) for:

Women age 21 and older who have inconclusive Pap test results

Cervical cancer screening for women ages 30 and older. HPV tests are not approved for routine use with women in their 20 and younger because HPV infections in this age group are very common and tend to clear quickly. In women 30 and older, HPV infections are less likely to clear on their own, so HPV tests help to determine which women need more follow-up.

Treatment

Genital warts: There are several methods to treat warts. Some treatments are done in a clinic or doctor's office and might involve surgical removal or medication applied to the skin; others are prescription creams that can be used at home. Warts sometimes clear on their own, so treatment is not always needed. Note: Over-the-counter treatments for common warts should never be used with genital or anal warts.

Cervical cell changes: Treatment of cervical cell changes depends on the exact results of the Pap test (and HPV test, if one was done). Mild cell changes often clear naturally, so healthcare providers often take a "wait and see" approach where a woman simply returns for frequent follow-up exams. When treatment is indicated, it typically involves an out-patient procedure to remove the abnormal cells.

HPV, you, and your partner

Keep in mind that it HPV infections are extremely common – almost all sexually active people have HPV at some point.

HPV is often found in individuals in long-term relationships, and can be detected weeks, months, even years after someone contracts the virus. In most cases, it's impossible to tell how long someone has had the virus.